دورية أكاديمية
أعرض في EDS

Weight-Based Dosing for Venous Thromboembolism Prophylaxis in Spinal Trauma Patients Appears Safe.

التفاصيل البيبلوغرافية
العنوان: Weight-Based Dosing for Venous Thromboembolism Prophylaxis in Spinal Trauma Patients Appears Safe.
المؤلفون: Heye T; University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Thind T; University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas., Jenkins A; Department of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Reif R; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Jensen HK; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Sexton K; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Biomedical Informatics, UAMS College of Medicine, Little Rock, Arkansas; Department of Health Policy and Management, UAMS Fay. W. Boozman College of Public Health, Little Rock, Arkansas; Division of Pharmaceutical Evaluation & Policy, Department of Pharmacy Practice, UAMS College of Pharmacy, Little Rock, Arkansas., Kalkwarf K; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Bhavaraju A; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: avi99@uams.edu.
المصدر: The Journal of surgical research [J Surg Res] 2023 Oct; Vol. 290, pp. 209-214. Date of Electronic Publication: 2023 Jun 06.
نوع المنشور: Multicenter Study; Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Anticoagulants* , Venous Thromboembolism*/epidemiology , Venous Thromboembolism*/etiology , Venous Thromboembolism*/prevention & control, Humans ; Cohort Studies ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Hemorrhage
مستخلص: Introduction: Venous thromboembolism (VTE) is a substantial cause of morbidity and mortality in trauma patients. VTE prophylaxis (VTEP) initiation is often delayed in certain patients due to the perceived risk of bleeding complications. Our VTEP guideline was changed from fixed-dosing to a weight-based dosing strategy using enoxaparin in June 2019. We investigated the rate of postoperative bleeding complications with a weight-based and a standard dosing protocol in traumatic spine injury patients requiring surgical stabilization.
Methods: A retrospective pre-post cohort study using an institutional trauma database was conducted, comparing bleeding complications between fixed and weight-based VTEP protocols. Patients undergoing surgical stabilization of a spine injury were included. The preintervention cohort received fixed-dose thromboprophylaxis (30 mg twice daily or 40 mg daily); the postcohort received weight-based thromboprophylaxis (0.5 mg/kg q12 h with anti-factor Xa monitoring). All patients received VTEP 24-48 h after surgery. International Classification of Diseases codes were used to identify bleeding complications.
Results: There were 68 patients in the pregroup and 68 in the postgroup with comparable demographics. Incidence of bleeding complications in the pre- and postgroups were 2.94% and 0% respectively.
Conclusions: VTEP initiated 24-48 h after surgical stabilization of a spine fracture using a weight-based dosing strategy and has a similar rate of bleeding complications as a standard dose protocol. Our study is limited by the low overall incidence of bleeding complications and small sample size. These findings could be validated by a larger multicenter trial.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
معلومات مُعتمدة: R01 GM111324 United States GM NIGMS NIH HHS; UL1 TR003107 United States TR NCATS NIH HHS; KL2 TR003108 United States TR NCATS NIH HHS; TL1 TR003109 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: Deep venous thrombosis; Prophylaxis; Pulmonary embolism; Spinal trauma; Venous thromboembolism
المشرفين على المادة: 0 (Anticoagulants)
تواريخ الأحداث: Date Created: 20230607 Date Completed: 20230710 Latest Revision: 20231124
رمز التحديث: 20231125
DOI: 10.1016/j.jss.2023.04.019
PMID: 37285702
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2023.04.019